Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $73.37 / $73.37 / $157.25	Facility	26	$73.37	$73.37	$157.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $139.16 / $188.72 / $369.06	Professional		$139.16	$188.72	$369.06
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $42.89 / $58.40 / $110.09	Professional	26	$42.89	$58.40	$110.09
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $107.75 / $136.50 / $193.59	Professional	TC	$107.75	$136.50	$193.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.33 / $230.48 / $235.08	Professional		$115.33	$230.48	$235.08
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $35.19 / $67.94 / $69.29	Professional	26	$35.19	$67.94	$69.29
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $162.54 / $162.54 / $162.54	Professional	TC	$162.54	$162.54	$162.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $230.66 / $230.66 / $230.66	Professional		$230.66	$230.66	$230.66
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $73.37 / $73.37 / $73.37	Professional	26	$73.37	$73.37	$73.37
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $157.29 / $157.29 / $157.29	Professional	TC	$157.29	$157.29	$157.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $109.32 / $179.18	Professional		$46.04	$109.32	$179.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $143.13 / $216.81 / $292.16	Professional		$143.13	$216.81	$292.16
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.02 / $67.13 / $92.93	Professional	26	$45.02	$67.13	$92.93
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $98.56 / $148.69 / $199.23	Professional	TC	$98.56	$148.69	$199.23
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $178.47 / $265.05 / $270.33	Professional		$178.47	$265.05	$270.33
Qualchoice Facility/Professional Professional Modifier 26 Low / Median / High Price $78.13 / $78.13 / $79.68	Professional	26	$78.13	$78.13	$79.68
Qualchoice Facility/Professional Professional Modifier TC Low / Median / High Price $186.92 / $186.92 / $186.92	Professional	TC	$186.92	$186.92	$186.92
United Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $212.61 / $292.66	Professional		$151.91	$212.61	$292.66
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.59 / $66.58 / $93.07	Professional	26	$44.59	$66.58	$93.07
United Facility/Professional Professional Modifier TC Low / Median / High Price $104.87 / $146.03 / $217.08	Professional	TC	$104.87	$146.03	$217.08